动机性访谈在肥胖男大学生个体化体质量干预计划中的应用-东南大学学报医学版

动机性访谈在肥胖男大学生个体化体质量干预计划中的应用

单位：北京交通大学社区卫生服务中心, 北京 100044

分类号：R193;R055

出版年·卷·期（页码）：2023·42·第一期（124-131）

摘要：

目的：探讨家医团队掌握动机性访谈技术对肥胖男大学生体质量控制效果的影响。方法：以北京某高校64名肥胖男性大学生为研究对象，随机分为干预组和对照组，对照组给予一般健康指导，干预组由家医团队在健康指导基础上应用动机性访谈技术，进行为期1年的饮食和运动管理。从人体测量学和临床检测指标、饮食和运动行为干预效果比较干预前后两组大学生体质量的变化情况。以体质量下降≥5%为减重有效的判定标准。结果：两组体质量指数（BMI）随时间改变均呈下降趋势，干预组BMI由（30.1±1.9） kg·m^-2降至（28.6±2.7） kg·m^-2（t=2.659，P=0.01），对照组由（30.7±1.9） kg·m^-2降低到（30.5±3.8） kg·m^-2（t=0.335，P=0.739）。重复测量方差分析结果显示，不同组别随时间下降趋势不同，干预组下降更明显（F=5.034，P＝0.032）。干预组减重有效的人数多于对照组（P<0.05）。干预组减重有效者，其甘油三酯、血压、腹型肥胖、脂肪肝及代谢综合征的改善明显（P<0.001）。结论：动机性访谈能够促进大学生行为改变动机，改善肥胖学生的膳食结构和运动行为，有效减重。

Objective: To explore the effect of motivational interviewing(MI) on weight control of obese male college students, in order to provide evidence of better health management for primary care providers(PCP). Methods: 64 obese male freshmen in a certain university in Beijing. Participants were randomly divided into intervention group(n=32) and control group(n=32). The intervention group received individual MI and conducted a one-year diet and exercise management. The control group received normal follow-up. Outcomes included anthropometric and clinical test indicators, diet and exercise behavior. Weight loss ≥ 5% was the standard of criterion for effective weight loss. Results: The body mass index(BMI) of the two groups decreased with time. The BMI of the intervention group decreased from(30.1±1.9) kg·m^-2 to(28.6±2.7) kg·m^-2(t=2.659, P=0.01), and that of the control group decreased from(30.7±1.9) kg·m^-2 to(30.5±3.8) kg·m^-2(t=0.335, P=0.739). The results of repeated measures ANOVA analysis showed that the decline trend of different groups was different over time, and the decline was more obvious in the intervention group(F=5.034, P=0.032). The number of effective weight loss in the intervention group was more than that in the control group(P<0.05). In the intervention group, triglycerides, blood pressure, abdominal obesity, fatty liver and metabolic syndrome were significantly improved(P<0.001). Conclusion: MI can promote obese students to conduct balanced diet, keep exercising and lose weight effectively.

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